The CT scan of the abdomen is from a 72-year-old female who presented with acute abdominal pain. Image A is an axial projection through the cecum, and image B shows the cecum and ascending colon reformatted in the coronal plane. The images show an accumulation of air within the wall of the cecum (arrows), a finding that is characteristic of pneumatosis coli. Associated radiolologic findings include the lack of formed stool in the colon reflecting loss of mucosal function, thickening of the peritoneum and lateral conal fascia (arrowhead), and ascites (dashed arrow). No portal venous air was evident. In the appropriate clinical setting, the findings are highly suggestive of acute ischemia of the large bowel.
